Railways (South-East)

Derek Twigg: The Government encourage communities to support franchised local railway services via community rail partnerships. They recognise the role of voluntary organisations in running independent railways. They will not normally provide direct financial support for independent lines, but will consider working with local authorities to implement specific improvements where they are value for money.

Alistair Darling: I think I can. As my hon. Friend knows, my Department and I have been in discussion the Greater Manchester passenger transport authority, among others, about how we improve public transport, particularly bus services. The problem is that it is not possible for representatives of a local authority and two bus companies to sit down and reach an agreement about the adequacy of the bus service, matters of fares and so on. If we are to achieve greater demand management and introduce road pricing and other measures, there must be such an agreement. If we are to say to people, as in London, "Don't take your car, but get on to public transport", the public transport must be available in the first place. I am not satisfied that the present system of dealing with buses deals with that. I have said before that I do not want to go back to the pre-1986 legislation because that had its own problems, but I think we can make a quantifiable change in the way in which bus services are provided outside London. That is what we are discussing, and I hope to have something further to say in the not too distant future.

Hugh Bayley: Local authorities spend a great deal of Government money seeking to increase bus use by designating bus lanes, building bus shelters, improving disabled access and traffic management systems, and running information systems. However, that works well and increases bus use, which has happened in York, as my right hon. Friend said, only if there is a good partnership between the local authority and the bus company. Does he agree that it would be helpful if bus companies were to consult local authorities when they intend to raise fares or change timetables, rather than just inform them?

Richard Burden: What assessment he has made of the likely impact of developing Birmingham New Street station on the transport infrastructure of the West Midlands.

Alistair Darling: My hon. Friend is absolutely right. That station carries many more passengers than it was ever designed for, and it is essential not only for Birmingham and the west midlands, but for many other routes that run through the area. On any view, there will have to be a substantial public contribution, which may involve the railways funded by the Department for Transport, the Department of Trade and Industry or others. I hope that we will have a proposal in the not-too-distant future, because everybody agrees that we need to spend a considerable sum of money to improve that part of the network.

Si�n Simon: May I call a spade a spade: given the hopeless dithering and chaotic failure to take a lead of the Tory-Liberal administration on Birmingham City council, I invite the Secretary of State to take a personal interest on behalf of the Labour Government, to take the matter by the scruff of the neck and to intervene to sort out the disgrace that is Birmingham New Street station? We should have a 21st-century station for a 21st-century city, but we cannot leave it to the Tories and the Liberals, because they cannot do it.

Alistair Darling: We will complete the review as soon as we can, but it is important to carry it out thoroughly to ensure that we get it right.
	In relation to the amount of crime, it is true, as has been said, that the amount of reported crime has gone up. That is partly because all crimes are reported and recorded more accurately, but it is also the case, as the House will know, that there has been an increase in the amount of crime against individuals generally. We have increased the amount of officers and the amount of money available to spend on measures such as CCTVevery single penny of which, I must tell the hon. Gentleman, was opposed by the Conservatives at every opportunity. The House should be in no doubt that we are committed to doing everything that we possibly can to ensure that the railways are safe. The fact that increasing numbers of people are using the railways every year tends to suggest that the vast majority have confidence in the system. That said, there is clearly a lot more to be done in relation to the fight against crime, and we will ensure that British Transport police and other police forces have the resources they need to do that.

Stephen Ladyman: Security measures are in place that are designed to be proportionate and responsive to the prevailing level of threat. Those have been jointly agreed with the French Government to ensure comparability of standards. The measures are kept under continuous review by both Governments.

Jim Murphy: I would assume that the hon. Member for Vale of York (Miss McIntosh) would know the position in North Yorkshire better than I do. Nevertheless, I can tell her that public services have been transformed and personalised throughout the country through changes in IT. In North Yorkshire, like the rest of the country, most of those services are highly effective and our constituents use them. For example, they may renew tax discs and pay tax online and visit Directgov. If the hon. Lady genuinely wishes to know the specific position in her constituency, I shall investigate and get back to her.

Hugh Robertson: On a point of order, Mr. Speaker. I seek your advice in your capacity as guardian of the rights and privileges of the House, as I believe that the House may have been misled.
	On 12 January, in a point of order from this Dispatch Box, I drew attention to an inconsistency. The answer to a written parliamentary question that I had received on that date stated that UK Sport had not
	set an aspirational target for Olympic medals in . . . 2012.[Official Report, 12 January 2006; Vol. 441, c. 783W.]
	That was inconsistent with remarks to the contrary in UK Sport's annual report. You replied, Mr. Speaker, that if that answer was incorrect, it should be corrected by the Department for Culture, Media and Sport.
	I wrote to the Secretary of State immediately after your remarks, Mr. Speaker. I have yet to receive an answer. I also issued a freedom of information request for the documents relating to the issue. I received a reply this morning. It denied me access to those documents; however, owing to a mistake on the part of a civil servant, the document that I sought was included in the reply. The summary statessome of it is in bold type
	UK Sport's ultimate goal, in consultations with BOA
	that is, the British Olympic Association
	and our other partners, is to finish 4th in the 2012 Olympic medal table, finishing as top European nation.
	There is clearly a massive inconsistency between that and the Minister's statement that UK Sport had not set an aspirational target for Olympic medals in 2012. You can see why I believe that the House has been misled, Mr. Speaker.
	I have now raised the matter twice on points of order, and have received no response from the Department. I have written to the Secretary of State; she has not yet had the courtesy to reply to the letter. What further action can I take?

Mr. Speaker: The right hon. Gentleman says that is does not happen. I cannot instruct Ministers, but the hon. Member for Faversham and Mid-Kent (Hugh Robertson) should get a reply, and he will get a reply. I hope that the right hon. Gentleman is happy with that.

Edward Balls: I beg to move,
	That leave be given to bring in a Bill to make provision about the assessment of disabled children's needs; to amend the law relating to children; to place duties on local authorities and the National Health Service in respect of disabled children and their carers; and for connected purposes.
	In Britain today, there are some 770,000 disabled children7 per cent. of all the children in our country. Despite medical advances, the prevalence of disability is increasing. Since 1975, there has been a 62 per cent. increase in the number of disabled children. At this point, I want to pay tribute to the many thousands of parents, carers and teachers of children with severe learning disabilities, who work tirelessly day in, day out, to give children in their care all the opportunities, love and support that they need and deserve.
	One test of a civilised society is how it supports the families in greatest need. We know that disabled children and young people face multiple barriers to achieving their potential, or to sharing similar life chances to everyone else. We know, too, that severe disabilities place great burdens on families and close friends. Surveys show that it costs three times as much to bring up a disabled child, while for many parents the barriers to work are insurmountable. More than half of disabled children in Britain today live in poverty.
	Successive Governments have recognised our obligations to these families. The Government's recent report, Improving the Life Chances of Disabled People, which was masterminded by the Under-Secretary of State for Education and Skills, my hon. Friend the Member for Liverpool, Garston (Maria Eagle), set out the overarching children's policy framework and how it has evolved in recent decades: from the Children Act 1989, to the Every Child Matters Green Paper and the subsequent Children Act 2004. That report highlights how the Government are doing more to support disabled children and their families through measures such as extra cash help in the form of the child tax credit, a network of special educational needs co-ordinators, and section 8 of the national service framework for children. But we know that there is still a long way to go.
	Last December, I met the parents and teachers of Kingsland school in Stanley, in my constituency, to where younger children with severe and profound learning difficulties come from across the Wakefield district. Kingsland is truly a brilliant school. Highly praised by Government inspectors, it is the first special school in my district to receive the primary basic skills quality mark. As I have seen, the children have a great time every day, especially at lunchtime. But when I talked to a group of parents and teachers, I heard first hand how tough life can be. Head teacher Nitsa Wainwright explained to me how difficult the school finds it to access services such as speech therapy or physiotherapy outside the school term.
	Parents' biggest concern is the lack of reliable respite care. They described to me the great stress that both parents and siblings endure, especially during the holidays, when there is no school and such families are caring for severely disabled children 24 hours a day, seven days a week. They told me how much they value the chance of an occasional breakto go to the pub or on a trip to meet friendsand they explained how much more difficult life becomes when, as happens too often, their respite care is delayed, curtailed or cancelled because of staff shortages or problems with transport. These parents need more support, and I have been in contact with my local authority and primary care trust to represent their concerns. There is a real will in our district to make things better.
	I have also discovered that these families are not alone in their struggle. Contact A Family and Mencap tell me that thousands of parents across the country face similar problems. In Britain today, 3,000 children are on waiting lists for family-based short breaks; three out of 10 children wait more than a year for such a break; and six out of 10 of those in greatest need get no, or very few, breaks. It is no wonder that, according to a Mencap survey, eight out of 10 families with disabled children are at breaking point. Margaret Sparks, a school governor of Kingsland school, told me of her and her husband's huge struggle to get proper respite care for their daughter, Kathryn. As one parent said to me:
	Most of the time the organisational challenge of getting out together as a family can be too great and it's just too difficult. At least with respite care you have the hope of a chance of being able to go out and be a normal family and enjoy things like cinema or swimming which many people just take for granted. For us, respite care means the difference between doing normal things like this and actually cracking up as a family.
	My Bill aims to improve the services for families such as the ones whom I met in my constituency. It is supported by Contact A Family, the Council for Disabled Children, Mencap and the Special Educational Consortium, which have been working together for several years to raise awareness of the issues that the Bill addresses. It is also supported by a number of backers and supporters from all parts of the House, many of whom have campaigned for years for a better deal for disabled children and their parents. They include Members such as my right hon. Friend the Member for Coatbridge, Chryston and Bellshill (Mr. Clarke), who introduced disabled persons legislation in 1986, and who is chairman of the all-party group on learning disability.
	I also wish to pay tribute to the late Rachel Squire, the former Member for Dunfermline and West Fife, who was a patron of Contact a Family and a tireless campaigner on behalf of carers and disabled children and adults. She will be sadly missed.
	My Bill proposes three important changes that would improve the rights of disabled children and their families. First, it seeks to make clear in law for the first time that local authorities must assess disabled children and provide them with a range of services where those are assessed as necessary. Our research has shown that there is no duty to assess disabled children under the Children Act 1989 equivalent to that in the National Health Service and Community Care Act 1990, although that duty has been implied in case law and policy guidance.
	The Bill would give disabled children the right to a local authority assessment and to receive services. It would do so by proposing amendments to section 17 of the Children Act 1989, and by drawing directly on a previous and pioneering private Member's Bill, which became the Chronically Sick and Disabled Persons Act 1970. I am sure that the whole House joins me in paying tribute to the work of Alf Morris, now Lord Morris, whose work radically improved the life chances of disabled people in our country.
	Secondly, my Bill would give disabled children and their families an explicit right to short breaks and respite care. Under the community care regime, adult social service authorities are obliged to provide disabled adults with short breaks where the authority has assessed that such a need exists. However, no such obligation exists at present under the Children Act 1989. If enacted, the Bill would therefore empower parents in coming forward to ask for assessments and for the services and respite care they badly need.
	Thirdly, my Bill would also require NHS bodies to work co-operatively with local authorities to promote the health and welfare of disabled children in England and Wales, and enhance the delivery of services such as speech and language therapy.
	I know from my discussions with Ministers that they support the objectives of my Bill. I know that they intend to study its provisions in detail to see how and if it can be taken forward. I know, too, that Ministers are committed to using every lever at their disposal to deliver our manifesto commitment to
	ensure that services are designed to meet the additional needs of disabled children and their families.
	I look forward to further discussions and, in the forthcoming spending review, I hope that the Government can bring forward a cross-cutting public service agreement for disabled children, which can match resources with greater co-ordination between local authorities and the NHS to deliver, for families with disabled children, the care and support they badly need.
	I hope that we can make progress in giving parents with disabled children enhanced supportbuilding on what has already been doneso that every child in our country has the best start in life. Parents of children at Kingsland School told me that they need more support. I hope that my Bill can make it happen, and I thank the House for giving me the opportunity to present it today.
	Question put and agreed to.
	Bill ordered to be brought in by Ed Balls, Liz Blackman, Mr. Tom Clarke, Annette Brooke, Peter Bottomley, Mr. Iain Wright, Mr. Jamie Reed, Mr. Mike Hancock, Mr. Brooks Newmark, Helen Goodman, Tim Loughton and Paul Burstow.

Quentin Davies: The Secretary of State is quite right to listen to the consultation and to propose to amend the original Second Reading formulation. However, new clause 5 contains a potential anomaly, as it says:
	The appropriate national authority may make regulations
	to provide for exemptions. Theoretically, if the Bill is enacted and comes into force before the national authority makes those regulations the absurd prospect arises that it would be illegal to smoke in one's own home. Can the Secretary of State assure us that she will make sure that those regulations are made in time to prevent that anomaly arising?

Andrew Selous: Is it the case that there are no fewer than 165,000 workers who work in the private members clubs that would be exempted under new clause 5?

Patricia Hewitt: Let me make it clear that if Parliament should decide to exempt private members clubs, the regulations that followwhich will be subject, as I said, to the affirmative resolution procedurewill require members to have an annual vote on the smoking issue, and in order to fulfil our manifesto commitment to protect employees even in those exempt premises, smoking will be banned in the bar. Furthermore, we will review those and other provisions of the new law within three years.

Patricia Hewitt: As I have already said, I think that the arguments are extremely finely balanced. In the spirit of the free vote that we on the Government Benches will have, I intend to listen to the debate very carefully.
	If both the amendments and the new clause are passed, the smoking ban will cover all public places and workplaces, including all licensed premises and private membership clubs, as well. Only a few specific exemptions will be made, mainly for places that are essentially a person's home or personal space. If the amendments fall but the new clause is passed unamended, the smoking ban will cover all public places and workplaces, including licensed premises, but not genuine private members clubs. If the new clause falls, the smoke-free provisions that are set out in the current draft of the Bill will remainin other words, in that situation we will introduce regulations to exempt both membership clubs and licensed premises that do not prepare and serve food.
	I stress that in order to fulfil the promises that we made to the public in our manifesto, the Government are not prepared to accept any smoke-free provisions that are less comprehensive than those set out in the Bill when it was first published. I wish that there was similar clarity on the Conservative Benches, where the hon. Member for South Cambridgeshire (Mr. Lansley), who speaks on health, said 10 months ago that he favoured self-regulation and opposed a ban, but has I think now decided that he supports a banno doubt he will tell uswhile the leader of the Conservative party continues to say that he opposes a banunless, of course, the hon. Member for South Cambridgeshire is going to tell us that there has been a further flip-flop since this morning.
	Whatever the outcome of the votes on these two specific issues, this Bill marks a huge step forward for public health. It will make smoke-free the norm. It will protect non-smokers from passive smoking, make it easier for smokers to give up and save thousands of people's lives. I look forward to a fruitful debate and to hon. Members making their views known on exactly how far the smoke-free legislation should extend. I commend new clause 5 to the House.

Andrew Lansley: Better than the Labour party.
	I am sure that the House is pleased to see the Secretary of State here after her indisposition last week, although frankly, I think that she might have preferred to be diplomatically ill today. As I said on Second Reading, I believe that the Bill can contribute to a significant reduction in smoking. On Second Reading, the House resolved to achieve that reduction by means of a legislative ban. We did indeed debate on Second Reading and in Committee the question whether it could be achieved on a self-regulatory basis. Of course, there is evidence of a significant increase in the number of smoke-free places that are being established without legislation being enforced, but the issue before us today is in practice not whether we should have a ban, but what its extent should be.
	Let me be clear: smoking kills and it remains the largest cause of avoidable deaths in this country, and that mortality includes several thousand people each year who we believe die as a consequence of exposure to second-hand smoke. The greatest element of that problem is exposure to second-hand smoke in the home, to which the Secretary of State referred. The figures were clearly set out in November 2004 in the Scientific Committee on Tobacco and Health report: there is a 24 per cent. increase in the risk of developing lung cancer for non-smoking women whose partners are smoking men; there is a 37 per cent. increase in the risk of developing lung cancer for non-smoking men whose partners are smoking women; and there is a 19 per cent. increase in the risk of developing lung cancer for those who are exposed to passive smoke in the workplace.
	The risk of lung cancer is well understood; the risk of cardiovascular disease is less well understood, but arguably much more significant. The risk of developing lung cancer increases in direct proportion to the number of cigarettes smoked and the duration of smoking. Damage to the heart and arteries, however, seems to occur disproportionately at lower exposures, such as those experienced through exposure to second-hand smoke. Although passive smokers may have an uptake of tobacco smoke equivalent to only about 1 per cent. of that of an active smoker, the risk of their developing heart disease increases by 25 per cent.
	Last year, a study in the British Medical Journal estimated on that basis that more than three times as many people die from ischemic heart disease as a result of passive smoking as die from lung cancer. Evidence produced in the past four or five years suggests that small amounts of exposure to second-hand smoke can lead to substantial increases in the risk of developing cardiovascular disease.

Andrew Lansley: I recall the figure to which the hon. Gentleman has referred, although I think that it appeared in a different BMJ study. I do not dispute that a significant number of deaths have been and continue to be associated with exposure to second-hand smoke in the workplace, which is one of the reasons why we have always supported protection in the workplace. As we set out in our manifesto, the objectives of policy should be to reduce the incidence of smoking, to ensure that non-smokers are not exposed to smoke unless they want to be, to protect workers in the workplace and to ensure that children are not exposed to second-hand smoke. We set out that position in our manifesto; I said it again on Second Reading; and I have not departed from it. We are debating how those objectives will be achieved and the balances to be struck, which I shall discuss in a moment.
	As shadow Secretary of State for Health, I must saynot least to my hon. Friendsthat it is imperative on health grounds to stop unwanted exposure to second-hand smoke and potentially reduce the prevalence of smoking, especially among young people whose smoking habits tend to become entrenched in the workplace. The Secretary of State accepted that point when she introduced the Bill at the end of last year, but she then made a perverse and bogus distinction between pubs that serve food and those that do not. On Second Reading, we asked her to explain the health grounds for making such a distinction, but she offered no evidence on that point. However, given the effect of that on health inequalities, which was subsequently exposed in great detail by the Select Committee on Health, we knew that it was wrong when it was presented. I think that most Labour Members knew that it was wrong and, frankly, that the Secretary of State knew that it was wrong, but she would not admit it. Her acquiescence in the Airdrie and Shotts provisions was a failure on her part. She is condemned by the fact that she would not stand by her own instincts and, as Secretary of State for Health, by the views and recommendations of the chief medical officer.
	We now have the utter humiliation of the Secretary of State voting against her own legislation. Never before has a Government Minister brought forward a measure and voted against it in this way.

Andrew Lansley: I shall come to that in a moment. [Interruption.] Well, I will do better than the Secretary of State, because I will tell the House how I am going to vote. A few minutes ago, she appeared to extol the fact that she is giving a free vote to Labour Membersor her Whips are. We gave a free vote on Second Reading. The Liberal Democrats did not, but have been persuaded to do so by the changes that we have brought about. I recall that on Second Reading, Labour Members endorsed our view that this matter should be governed by a free vote because of the contrary views and evidence that needed to be listened to.
	The Secretary of State would not listen, and now she has had to learn. Curiously, however, we do not know quite how far she has gone. In new clause 5, she has abandoned the prospect of an exemption for non-food pubs. Whereas previously she was prepared to consult on whether there should be smoking rooms in licensed premises, she now seems to have concluded that there cannot be such a consultation and must not be such smoking rooms. I did not hear her express a view on the remaining central question relating to clubs. Presumably we can have a debate about that, and in two and a half hours we will all be very excited to see whether she is for or against it. On Second Reading, she said:
	It is . . . right to exempt membership clubs.
	She said of members of the public:
	They clearly view membership clubs as private clubs run by members for members. Such clubs have always been treated differently from other licensed premises because they are non-profit-making organisations.[Official Report, 29 November 2005; Vol. 440, c. 156.]
	That was the Secretary of State's advice on Second Reading, but given the handbrake turn that we have seen since then, what point is there in taking her advice? Even her own junior Minister, the Under-Secretary of State for Health, the hon. Member for Don Valley (Caroline Flint), is not going to do soor perhaps it is vice versa; we simply do not know.

Steve Webb: The hon. Member for Ealing, North (Stephen Pound) is a tough act to follow. Although I have been the butt of his humour, I think that the Standing Committee might have been greatly enhanced by his presence.
	At the heart of this debate are the health and safety of people working in pubs, clubs and enclosed public spaces. That has to be our starting point. It is welcome that the Government have got rid of the absurd distinction between food and non-food pubs.
	In the Standing Committee, on which I served, and on Second Reading, the House was told why a gradualist approach was the thing to do: any country that introduced a ban had done so gradually, so the food/non-food distinction was a vital part of the effective implementation of the policy. Some weeks later, it is apparent that that was nonsense and that the Government knew it all along, so at least we have made some progress on that front.
	I am trying to work out what constitutes a rebel nowadays, because we seem to have reached a never-never world. The Secretary of State has tabled an amendment in defiance of her party's manifesto and her junior Minister has tabled an amendment to the right hon. Lady's amendment, while the Department of Health press release, issued on 2 February, stated:
	Although the New Clause has been tabled in Patricia Hewitt's name and the Amendment in Caroline Flint's name, this is simply in order to facilitate a free vote and does not necessarily indicate which way either will vote themselves.
	That is an incredible situation and, even today, in response to an intervention, the Secretary of State said that she had not made up her mind. One can understand the merits of a free vote, but the idea that the Secretary of State, who is responsible for the health of the nation and thus, to some extent for the health and safety of workers, does not know what she thinks is extraordinary. Indeed, the whole sequence of events has shown a lack of leadership by the Government. They tried to discern and follow public opinion, realised that they were running behind it and so they are trying to play catch-up. That is no way to set a health policy.
	The key question is about the principal bone of contentionthe position of private members' clubs. If we consider the matter, as I have done throughout, in terms of the health and safety of people who work in those environments, the fact that I am breathing in the second-hand smoke of someone who happens to have a membership card is irrelevant. The fact that they have agreed with other club members that they have the right to smoke, and I am expected to breathe it in, is irrelevant. The club is not home and people are inflicting smoke not on themselves or their loved ones, but on other people.

Steve Webb: I understand the hon. Gentleman's point. I suspect that the reason is more to do with pragmatism than anything else, but I am making an argument about private clubs. The Secretary of State says that 95 per cent. of passive smoke comes from the home, as though the other 5 per cent. is somehow inconsequential, yet we have heard that we are talking about a very large number of people whose health is clearly adversely affected and, probably, thousands of premature deaths over a period of years. Although I enjoyed the comments of the hon. Member for Ealing, North (Stephen Pound), perhaps we need not be apocalyptic, but such things are fundamentally important to each individual case.

Steve Webb: Not only is the hon. Gentleman right, but that might be the outcome even if the House tried to make such a distinction. The idea that there would be a set of workers who had second-class protection seems unsustainable. Even if that were the will of the House today, I have a feeling that the issue would return here via the courts very soon.
	I wish to make further observations about some of the arguments that are used for exempting private members' clubs. The first is that we have some sort of carriage in which people would not have to work. People would presumably have to get in and out of such rooms and smoke goes to and fro. People would also have to clear the glasses in such rooms and sort out any scuffles that might take place. Smoke will remain in such areas, especially if they are sealed, for a considerable time. Without the ventilation found in a Jumbo jetI gather that it is what it would take completely to purify the airthere will be residual toxins in the air. The well-being of the workers cannot be protected just by having a partitioned-off room.
	We have made progress on the Bill, but clearly we have not gone far enough. There is a balance of liberties to consider. People want to be able to smoke and they will still be able to do so in their own homes and out of doors, but it is the job of the House to protect the liberty of people to work in an environment that does not potentially fatally damage their health. That is why I have argued consistently throughoutI will again vote for this in the Lobby tonightthat a total ban is the only proper approach to the issue.

Kevin Barron: I said earlier that when the Under-Secretary of State for Northern Ireland, my hon. Friend the Member for St. Helens, South (Mr. Woodward), made a statement on comprehensive legislation on the matter for Northern Ireland, which will be considered in the House because of the suspension of the Assembly, he said that ventilation did not work. We examined ventilation and found no evidence to support its use. An academic from the university of Wales could supply us with no evidence that air conditioning works. It might work if there was a system such as that in a hospital theatre, but opening windows and doors does not protect bar workers.
	If, as I expect and hope, this proves to be a good day for Parliament, I suggest that it will also be a good day for the Select Committee system. Let me summarise what the Committee found. First, scientific evidence on the health effects of second-hand smoke is clear and overwhelming. We accept the verdict of the Government's advisers from the Scientific Committee on Tobacco and HealthSCOTHthat exposure to second-hand smoke increases the risk to non-smokers of heart disease and lung cancer by about a quarter.
	In most, although not all, cases, the tobacco industry continues to deny such evidence. Representatives of the industry continued to pursue that line when they gave evidence to the Committee. However, it should not be forgotten that for many years the industry denied in public that direct smoking was a cause of cancer, although its private view was very different. Indeed, action that was taken in the United States meant that it opened its archives, which gave us evidence that it knew about the consequences of direct smoking years ago, but hid those facts.

Kevin Barron: I could not agree more and will come on to that point.
	Health and safety concerns are sufficient reason for resisting the Government's original plans to exempt from smoke-free legislation pubs that do not serve food. Why should workers in such pubs be denied the protection that other workers are to be given? It is nonsense to think that we should pass such a measure in the House. Health and safety concerns are sufficient reason not to exempt membership clubs from the law. Licensed clubs employ bar staff, who are routinely exposed to other people's smoke. The fact that the clubs in which they work are owned by members does not afford them any protection from lung cancer or heart disease. The notion that club members should be able to vote to continue to expose their workers to such risks is unacceptable. I came to the House after working for 18 years in one of the most dangerous industries in the United Kingdom. It would be unacceptable for Parliament to pass legislation on that industry by ignoring fundamental facts, but the Bill attempts to do so on smoking.
	It is farcical to suggest that a private members' club is an extension of the home. I have been a member of a club for many years, but clubs are not as private and secluded as my right hon. Friend the Secretary of State suggested on the radio this morning. A member of a club in the Club and Institute Union can affiliate to the wider union for 3 a year, and can go to 2,600 clubs and buy a drink without anyone preventing them from doing so. Royal British Legion clubs, too, are not exclusivea member of the British Legion can walk into any of its clubs and be served a drink.
	The hon. Member for South Cambridgeshire (Mr. Lansley) raised the issue of children. Clubs differ marginally from public houses, because there are often many children inside them. They are family-oriented and many hold weekly discos for young children. They organise Easter bonnet parades, Christmas functions and so on for families and young children, so the proposal to exempt clubs from the smoking ban is ludicrous.
	If Members do not believe that it is reasonable and practicable to protect people in the workplace under the Health and Safety at Work, etc. Act 1974, they should wait until the House passes the smoking legislation and see what the no win, no fee lawyers do to clubs trying to secure indemnity insurance. In its evidence to the Select Committee, the Health and Safety Commission clearly recommended that pubs, bars and clubs should be covered by the law in the same way as every other workplace. That view is shared by the TUC, which passed a motion nem. con. in congress in September to ban smoking in all workplaces. The Union of Shop, Distributive and Allied Workers, which represents more than 640 bar workers in clubs, wants a ban, and issued a press release on FridayI am sure that Members have seen itin which general secretary John Hannett said:
	Our members are already reporting that they can get a lot of abuse when asking club members to stop smoking at the bar, which is already illegal.
	That is not, in fact, illegal in private clubs but only illegal in public bars. Mr. Hannett continued:
	So we think this amendment will make sure our members can work free of abuse from customers and free from abuse of their lungs.
	Why should club bar staff have to try to enforce the farcical measure whereby someone is not supposed to smoke near the bar?
	When the Under-Secretary of State for Health, my hon. Friend the Member for Don Valley (Caroline Flint) gave evidence to the Health Committee, I asked her about clubs that offer entertainment. If someone is working on the stage, will the Government say that we should stop people smoking near the stage? At a reception earlier today, I was talking to Fiona Castle, the widow of Roy Castle, who we all know contracted lung cancer without ever smoking a cigarette in his life. Many people think that that was because of the secondary smoke that he inhaled in his career as a club entertainer. It is nonsense to think that we can protect people from secondary smoke if exemptions such as the one proposed are made.
	Let me offer one more quote from somebody who works behind a barnot somebody who goes into a bar by choice, but somebody who gets a living behind a bar. Another of the staff whom USDAW represents says:
	If we are exempt from this ban, even more smokers are going to come in, and the smoke will get even worse.
	What have they done to deserve that? If a person can move from a pub in my village to a club over the road to smoke, that will make matters even worse not just for bar workers, but for other people in the club.

Kevin Barron: That is a matter for the Government. If a comprehensive ban is agreed tonight, it is crucial that it is enforced in a way that means that everybody understands where one may smoke and where one may not smoke. Unfortunately, my hon. Friend the Member for Ealing, North (Stephen Pound) is not with us. I had one or two things to say to him about that.
	If hon. Members are not persuaded by the health argument, what about the economic argument? To force some pubs to make a choice between stopping people smoking and stopping serving food would create a gross and unjustified market distortion, as well as making a mess of the Government's alcohol strategy and worsening health inequalities. To force pubs that cease to allow smoking to compete with bars and clubs in the same street that still permit it would be unfair and unreasonable.
	Like many other hon. Members, I have received representations not just from the industry, but from local publicans. I have one from Steve Smith and Wendy Edwards of The Thurcroft, a public house in one of the villages in my constituency. I know that public house very well. Five hundred yards down the road is Thurcroft Miners Welfare, and five hundred yards up the road is the Unity club, or the top club, as it is known in the village. The income of those people will be threatened directly if the ban suggested in new clause 5 is introduced.
	I received a letter from Mr. Jan Sowa, who runs a small company that runs three pubs, one of which is The Blue Bell in Aston, another village in my constituency. That pub, too, will be under threat if smoking is allowed in clubs. I do not want to see small businesses such as pubs close down because of what the House does. I hope that other hon. Members do not want to see that either. That is why the British Beer and Pub Association, the British Hospitality Association and many others in the leisure and tourism industry now support comprehensive legislation. They see the dangers to businesses.

David Lepper: Does my right hon. Friend agree that there is a point at which economics and health are linked? The landlord of a pub in my constituency, Chris Beaumont of The Greys, which is the only Egon Ronay-listed pub in Brighton, points out to me that he wants to carry on serving food, but there are 17 other pubs and two clubs within a square mile of his premises. If the sort of measures suggested in new clause 5 are not introduced, people will either leave his pub to drink elsewhere or he will have to stop serving food. He points out to me, however, that if there were a total ban on smoking in all pubs, his customers would simply have to get used to it and possibly stop smoking

Kevin Barron: That is true, but as I have already intervened on that matter, I shall not go any further.
	The new clause and amendments (a) to (d) would bring England into line with the law that is soon to come into effect in Scotland, that has now been promised in two votes by the National Assembly for Wales and that the Government have announced for Northern Ireland, on which I suspect we will legislate in the next few months. I hope that hon. Members from all three countries will see no difficulty in joining us in giving the same protection to workers and members of the public in England that the rest of the United Kingdom is getting.
	The tobacco industry and its allies often argue that smoke-free laws are an infringement of liberty, but I suggest that, once it is accepted that breathing in other people's smoke is dangerous to health, we will recognise that we are really dealing with a conflict of interest. I recognise people's right to smoke and tobacco is a lawful product. Smoking may be self-destructive, but it is ultimately a matter of choice. I say to people, including my hon. Friend the Member for Ealing, North, that people in the Irish Republic make that choice. They step outside into unconfined spaces and still enjoy drinks and cigarettes as well without affecting other people in the pub, including bar workers. That view is certainly widely shared by the general public. Recent polling shows that about 70 per cent. of the public back comprehensive smoke-free legislation, including all pubs and bars.
	Finally, I want to mention the enormous public health benefit offered by smoke-free legislation. One in four adults in our country still smoke, and more than 100,000 of them will die as a result. It is by far the greatest cause of preventable deaths and the biggest single contributor to health inequalities and the difference in life expectancy between social classes. I see that my hon. Friend the Member for Ealing, North has found some fun in the matter, but I have great difficulty in making jokes about it.
	The Government's figures in the regulatory impact assessment suggest that a comprehensive smoke-free law would reduce smoking prevalence rates by 1.7 per cent. That would mean 700,000 people giving up smoking across England, which would lead as night follows day to thousands fewer dying each year from cancer, emphysema, peripheral vascular disease and other illnesses that can be caused by smoking. Over time, that would decrease health inequalities, which are far too great in many parts of this country.
	Last night, the House debated ID cards, including how useful they will be in preventing terrorism and saving lives. Tomorrow, we will debate the Terrorism Bill, and again the question will be how useful the legislation is in saving lives. Tonight, if hon. Members vote for amendments (a) to (d), they will do so in the certain knowledge that the legislation will save lives and drastically improve the health of our constituents.

Roger Gale: Amendment No. 8 would delete part 1 of the Bill in its entirety, which would force the Government and, dare I say it, Her Majesty's official Opposition to think again.
	This evening, we have heard a series of arguments shot full of inconsistencies. In his peroration, the hon. Member for Northavon (Steve Webb) said that he would vote for a total ban. Oh no he will nota total ban is not on the agenda. If hon. Members on both sides of the House believe that smoking is so bad for one's health, that those who work bars, restaurants and private clubs suffer so much, and that 95 per cent. of the damage done by secondary smoking is done in the home and only 5 per cent. in other locations, surely, without looking too closely at the emperor's clothes, the argument must be that smoking should be banned altogether. People who do not adopt that approach are a little bit pregnant, and they must decide how far they are prepared to go down that ludicrous road.
	I do not smoke and I am asthmatic, but I believe that while the law of the land says that smoking is legal, the British publicthe English publicshould have the choice whether to smoke in smoking clubs, pubs and restaurants. They should also have the choices not to smoke in non-smoking clubs, pubs and restaurants and whether to work in such establishments. I do not know a single employee who has had a gun held to their head and been told, You must go and work in that pub, where they allow smoking.
	There is an answer but it is not on offer, which is why those. Members who support amendment No. 8 want to delete part 1 of the Bill and make the House think again. The answer is that every drinking establishment, club, restaurant and pub is licensed to sell alcohol, and it does not take a great leap of imagination to work out that it is possible to licence every pub, club and restaurant to be either smoking or non-smoking. The public and employees would then choose which type of establishment they want to patronise, and they will choose smoke or smoke-free. I have no problem with making the installation of cleansing equipment a condition of obtaining a smoking licence. It has been said in this House this evening that air conditioning does not work, but we are not talking about air conditioningwe are talking about air purification. Air purification systems do work. It is eminently reasonable to say that if a publican wants to have a smoking pub he should invest in the machinery that will keep the air clean for the benefit of the staff.
	We know perfectly well that the Exchequer could not bear the cost of banning smoking, which is why there will be no smoking ban. We know that prison staff could not control prisons, which is why there will be no ban on smoking in prisonsit has nothing to do with the health of the prison staff. The debate to date has reeked of hypocrisy, and we need to get some common sense and consistency into it. I urge the House to dismiss this whole package and think again.

David Clelland: I support the case for excluding private members' clubs from the ban. I am grateful to Ministers for giving all Members the opportunity to vote for a number of options, but I want to emphasise that clubs are different. That was outlined in the guidance issued under section 182 of the Licensing Act 2003, which states at paragraph 9.2:
	The 2003 Act recognises that premises, to which public access is restricted and where alcohol is supplied other than for profit, give rise to different issues for licensing law than those presented by commercial enterprises selling direct to the public.
	It says that those premises include
	Labour, Conservative and Liberal Clubs, the Royal British Legion, other ex-services clubs, working men's clubs, miners welfare institutions, social and sports clubs.
	Every one of us has several such establishments in our constituencies. The guidance acknowledges that
	the premises are considered private and not generally open to the public.
	It goes on to say:
	The Secretary of State wishes to emphasise that non-profit making clubs make an important and traditional contribution to the life of many communities in England and Wales and bring significant benefits. Their activities also take place on premises to which the public do not generally have access and they operate under codes of discipline applying to members and their guests.
	I am not a smoker, but I do not like smoke blowing in my face from smokers sitting nearby any more than anyone else does. Nor am I opposed to a ban on smoking in private members clubs. However, I believe that the decision on whether to ban it should be for the members of that club to make. That is the important principle that I wish to pursue.
	I do not refute the health arguments, although there is great deal of exaggeration in that regard, particularly when hon. Members accuse club members of killing their staff. That is a little over the top. As the hon. Member for North Thanet (Mr. Gale) pointed out, the Bill does not make smoking illegal. Smoking in private will still be legal. Unless we want to take the bull by the horns and ban smoking completely, some of the arguments smack of hypocrisy.
	We have long maintained in this country the right of people to form private clubs in which theythe membersdecide what legal activities go on. Clubs must be allowed to make those decisions for themselves and in their own time. They are democratic, non-profit-making organisations, and many of them are struggling. If this is forced upon them and they cannot make these changes in their own way and in their own time, many will close, and their staff, far from being in a smoke-free environment, will be in a work-free environment.

David Clelland: I shall consider the annual vote shortly, but I will not discuss the complexities of how the ballots should take place. That is for another day. Today, we are debating the principle of the matter.
	The licensed trade has argued that the Bill will sound the death knell of many pubs because people will move from pubs to clubs. Pubs have open access and far more freedom than clubs to introduce attractions that will bring in the public and lead to their continuing patronage. The bingo clubs and casinos claim that people will flock from them to private clubs. That is nonsense because people who patronise bingo clubs and casinos go for much bigger prizes than any working men's club could offer. They would certainly not be attracted merely by the ability to have a cigarette.
	If, as we are told, the non-smoking population is growing and the smoking population is declining, the non-smokers may migrate from the smoking to the non-smoking establishments. Banning smoking in pubs and restaurants may benefit rather than cause problems for those places. I do not therefore accept the trade's arguments. It is worried because it erroneously believes that the measure will give non-profit-making clubs an advantage. It is concerned about its profits, not anyone's health.
	The hon. Member for Northavon (Steve Webb) claimed that if exemptions were made, the Rose and Crown might turn itself into a private club. If he believes that, he does not understand the Licensing Act 2003. To become a private club, a pub has to satisfy all the conditions, including becoming a non-profit-making members club. I do not believe that the Rose and Crown wants to be a non-profit-making establishment, so it is unlikely to become a club.
	Many clubs already take action to restrict and even ban smoking on their premises. The annual ballot, which my hon. Friend the Member for Rhondda (Chris Bryant) mentioned, will accelerate the process. They will have to consider the matter annually and I am sure that the smoking restrictions will continue. Let us not use a good Bill to erode the traditional freedoms of our private clubs and, in too many cases, threaten their existence.
	I hope that when my hon. Friend the Under-Secretary responds to the debate she will clarify something that the Secretary of State said earlier. My right hon. Friend appeared to imply in a radio interview this morning, and in an answer that she gave me earlier, that there will be regulations to restrict smoking in any room where there is a bar. Today is the first time that we have heard that. The letter that the Secretary of State sent to clubs when the point was first queried stated:
	we will uphold our manifesto commitment to protect employees by prohibiting smoking in the bar area.
	That is completely different. If we are to impose a ban on smoking in every room in a club where there is a bar, we may as well include clubs in the overall ban.

David Clelland: I am not sure what the lack of clarity is. Clubs are dealing with those issues as we speak. There are already restrictions on smoking in the bar area and most club members uphold them. If they do not, they will not be club members for long. Clubs discipline their members if they do not stick to the rules.
	I do not opposeand I shall supporta smoking ban in public places, but I cannot accept that we should legislate against private members clubs in that way. It is against all our traditions. The best answer, as in so many cases, is education rather than legislation.

George Young: I want to make an extremely brief speech, as many other Members wish to speak in the debate. It was disappointing that the Secretary of State was unable to share with the House how she planned to vote on this matter. She is the Secretary of State for Health and this is one of the most important public health issues that this Parliament will debate. It would have been helpful if, under the protection of a free vote, she could have indicated to the House what her preference was among the options available to us. She said that she would listen to the debate. I have been listening to this debate for 30 years, and it would be astonishing if some new and decisive argument were to emerge in these two hours to clinch the debate one way or the other. The last time we debated this matter, she put forward a view, constrained by collective responsibility, with which we know she disagreed. Against that background, and with the protection of a free vote, it would have been helpful if she had been able to tell us her views on this occasion.
	I want to pay tribute to the work of the Select Committee. It was courageous of the Committee to confront head on a pledge in the Government's manifesto, six months after the general election. The role of the Select Committee has been decisive in this debate and it is a model of what Select Committees should do. It detected an argument that had unsound foundations, exposed it, then produced a clear, unambiguous, unanimous report that has been of enormous assistance to the House.
	I want to pick up a point made by the hon. Member for North-West Leicestershire (David Taylor), and I make no apology for raising the West Lothian question. In the Standing Committee, we had a vote on whether the distinction between pubs that serve food and those that do not should be removed. The Government won by one vote, that of a Scottish Member whose constituents will have the benefit of a comprehensive ban. His vote was decisive at that stage in ensuring that my constituents would not have the benefit of such a ban. At some point, the Government will have to address that issue, because it is going to recur time and again.
	I hope that, at the end of this debate, Parliament will send out the clear signal that smoking is a harmful activity that it wishes to discourage. My concern, however, is that we are about to remove one indefensible distinction, namely, the distinction between pubs that serve food and those that do not, with another indefensible distinction, namely, that between pubs and clubs. As the right hon. Member for Rother Valley (Mr. Barron) has just explained in his excellent speech, no public health argument, no employment argument and no public nuisance argument can be used to distinguish private clubs from pubs. He also explained that the barrier between a private club and a pub is a very narrow onea 3 subscription will give access to a wide range of clubs. The tobacco industry wants a confused signal to emerge from Parliament that smoking is an activity that can be validated in certain circumstances. It would be much better to send a clear message that people can, of course, smoke in private but that smoking in a public place is something that Parliament wishes to discourage.

John Bercow: And the Clean Air Act 1993.

Tony Wright: It is always a great pleasure to follow the right hon. Member for North-West Hampshire (Sir George Young). I wish that he had also mentioned the historic connection between the beer industry and the Conservative party, but apart from that he made some excellent points. I do not want to repeat them, but I want to emulate him by being similarly brief.
	We should celebrate the fact that this matter is being decided on a free vote. That is good for Parliament. I know that we cannot resist the temptation to revert to type by teasing Ministers about this, but it is good that we should approach issues in this way and that Ministers should, quite legitimately, take different views on a matter of judgment. We cannot both celebrate the free vote and attack Ministers for doing that. The more that we can decide issues in this way, the better it will be for Parliament, and not just because it is sometimes politically convenient.
	It is a good thing that we are going to ban smoking in public places tonight, but it is extraordinary that we did not do it a long time ago. It is such an obvious public health measure and Parliament should have turned its attention to it long ago. My only dissent from what is being proposedI do not think that it will be tested in the Division Lobbyis that we could have taken a much simpler approach from the beginning. We should simply have proposed to separate the smokers from the non-smokers. The distinctions that the Government originally introduced were not sustainable. The idea that we should distinguish between pubs that served food and those that did not had no foundation in any public health argument. Nor do I believe that the distinction between pubs and clubs is sustainable. Some hon. Members have argued forcefully about the freedom involved in private members clubs being allowed to do their own thing, but that argument is trumped by the view that basic protections should be afforded to the workers involved, and that overrides the distinction. Those workers would not have the freedom not to be exposed to other people's smoke.
	Those distinctions must fall away, but it would have been easier to carry public opinion with us on this by adopting a simpler approach, such as the introduction of some kind of physical segregation in all kinds of premises between the smoking area and the small non-smoking area. I would have imposed onerous conditions on the smoking area involving physical separation and the sealing of rooms, and allowing no children, food or drink. I might have added provisions about sophisticated ventilation equipment

Christopher Chope: I wish to speak to amendment No. 6, on which I hope that we shall have the chance to vote later. I am delighted that my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) is lending his support to it. The amendment has come as quite a surprise to many of my right hon. and hon. Friends, because they did not realise that the coercive powers that the Government are taking under clause 5 include the power to ban smoking in private motor vehicles. It would be wrong in principle to do such a thing, as well as totally impractical. I have yet to hear the Government offer any defence for taking this power, and, in the absence of any such defence, I hope that the whole House will support my amendment.
	I also want to address the issue of prisons. The Government line is that smoking is bad for our health and that of those around us. If that is so, why is smoking still to be allowed in prisons under the Bill? I asked the Secretary of State, in an intervention, why there was a rule about prisons that was different from the rule proposed for clubs and other licensed premises. I did not really receive an answer.

Alasdair McDonnell: I too will be brief, or as brief as I can. I think we could generate an awful lot of nonsense. Perhaps I should apologise, as someone from Northern Ireland, because the Under-Secretary of State for Northern Ireland, the hon. Member for St. Helens, South (Mr. Woodward), has relieved us of responsibility: he has done the wise thing, and provided for a total ban in a few months' time. I hope that the right hon. Member for North-West Hampshire (Sir George Young) will allow my vote tonight in favour of a stronger ban to cancel out the irresponsible vote of someone else.
	Smoking is a killer. Smoking maims people. Smoking cripples people. There is a whole spectrum of damage that smoking cigarettessmoking tobaccodoes to people. It is the single greatest cause of serious morbidity and mortality, and one of the single greatest burdens on the national health service owing to the illness that it causes. Others have spoken on the subject, and I do not want to go into the details of the damage to lungs, chronic obstructive pulmonary disease and emphysema. Smoking does even more damage to the cardiovascular system. There is brain damage, stroke damage and all the rest. We could split hairs on whether we stop that a little bit, a bigger bit or completely, which is as far as we can go. By completely I mean stopping smoking in public places completely; I do not accept that there can be an absolute ban on smoking, although I should like to see the day when that might happen.
	Excuses are being made in relation to private spaces: clubs, private homes and vehicles. I do not think that anyone would suggest that people should be allowed to grow cannabis in their private homes or private spaces, and put it to whatever use they like, including the corruption of younger people. The reality is that smoking is damaging, and we in the House have a responsibility to ensure that the amount of damage it is allowed to do is limited.
	Apart from the damage that smoking does to people, the cost to the national health service is awful. Smoking is crippling the NHS. As a result of the smoking that has taken place over the past 25 or 30 years, we shall have a legacya mortgageof debt hanging over us for the next 30 years, until we remove smoking, reduce smoking or control smoking.
	Before I came to the House I was a GP. Smoking, the damage done by it and the challenges involved in stopping presented me with one of my own greatest challenges. Trying to stop smoking is a difficult issue: it all comes down to individuals. A GP can do anything he likes to help people, but the biggest pitfall is what happens on a Friday or a Saturday night, or at the football match at the weekend. When there is a social occasion, people slip back on to the cigarettes. We must ensure that we give those people as much support as possible.
	The southern Irish experience has been extremely positive. Faults can be found in it: there are breaches of the law, and people stand outside bars smokingbut even that has turned into a benefit, because matches are now being made outside the pub rather than inside. There is a smokers' club outside the door. Let us be serious, however. The Irish experience has worked. Smoking is down, and good public health is rising. It will be many years before that shows its full benefit, but I appeal to Members for God's sake to give people a chance. People are struggling to give up cigarettes. Most sensible people who are smokers want to stop smoking, and want us to help them to stop. We should not put any further obstacles or difficulties in their way.

Howard Stoate: I am very grateful to my esteemed medical colleague for giving way on this important point. Does he therefore agree with me that because ventilation systems cannot remove these particulates in sufficient quantities, simply ventilating a pub's atmosphere will not reduce them to a safe level? He is therefore right to say that a total ban is the only credible way forward.

Hugh Bayley: In November, I wrote to my right hon. Friend the Secretary of State for Health and said that I could not in conscience support the then Government position of a partial ban that would not allow smoking in licensed premises where food was served. I sent a copy to my right hon. Friend the Chief Whip. I congratulate both of them on the decision that we should have a free vote on an issue that may be the most important public health decision that will be made by the Government in this Parliament.
	I have tried to assess the number of lives that could be lost if we had a partial rather than a full ban. The Jamrozik article in the British Medical Journal, mentioned by the hon. Member for South Cambridgeshire (Mr. Lansley) and my right hon. Friend the Member for Rother Valley (Mr. Barron), states that on 617 people die from passive smoking in the workplace each year on average and that some 54 of them work in the hospitality industry. If around one in three licensed premises were exempt from a smoking ban, around 20 people would lose their lives every year. That loss of life could be avoided if we choose a full ban.
	I have spoken to the Health and Safety Executive to try to make comparisons with other industrial hazards. Some 37 people die each year from falling from a great height, such as building workers falling from inadequately erected scaffolding. A club would not use the freedom of individual members to make a decision to agree to save money by putting up faulty scaffolding, thus putting at risk the lives of people who work for that club. They should not do the same with their employees by permitting smoking to continue.
	On the railways, seven workers died in line-side accidents in the most recent year for which I have been able to obtain figures. One would not say that wearing an orange bib and abiding by the railway inspectorate's safety regulations should be a matter of personal choice for a railway company or employee. We have health and safety rules to protect people, and we should protect people working in private clubs in the same way as we propose to protect those working in other licensed premises, such as restaurants and pubs.
	To those private clubs that wish to retain the right for people to smokeby no means all of them, since two private bingo clubs in my constituency have asked me to support a comprehensive banI would say that they will put off more people coming in through the smoky atmosphere than will be encouraged in by permitting smoking. The legal pressures that are likely to come on club committee members from the families of employees who suffer illness or death as a result of passive smoking should make them think again. I urge all hon. Members, including my right hon. Friend the Secretary of State for Health, to choose a consistent policy, protect employees in restaurants, pubs and clubs in the same way, and vote for amendments (a), (b), (c) and (d).

Caroline Flint: It has been quite a journey over the past eight months or so. This afternoon's debate has paralleled the discussion of the matter that has gone on in the public domain over that period. Speeches have been made by the hon. Member for Northavon (Steve Webb), my right hon. Friend the Member for Rother Valley (Mr. Barron), the right hon. Member for New Hampshire[Interruption.] I mean the right hon. Member for North-West Hampshire (Sir George Young). In addition, my hon. Friend the Member for Cannock Chase (Dr. Wright), the hon. Members for Belfast, South (Dr. McDonnell) and for Wyre Forest (Dr. Taylor), and my hon. Friends the Members for Selby (Mr. Grogan) and for City of York (Hugh Bayley) all argued that the legislation on restricting smoking in public places should go as far as tonight's votes allow.
	However, my hon. Friends the Member for Ealing, North (Stephen Pound) and for Tyne Bridge (Mr. Clelland), and the hon. Members for South Cambridgeshire (Mr. Lansley) and for Birmingham, Yardley (John Hemming), all felt that there should be more compromise on the matter. If I heard them correctly, the hon. Members for Christchurch (Mr. Chope), for North Thanet (Mr. Gale) and for Tewkesbury (Mr. Robertson) said that there should not be legislation in this area at all.
	This is an historic debate. We are celebrating this week the 100th anniversary of the parliamentary Labour party. It is fair to say that many of the most challenging pieces of health legislation over the past century have been introduced in the short periods of Labour Government. We hope to serve for much longer in the 21st century, but I am pleased and proud to be here this evening to endorse and put into law for the first time proposals that will restrict smoking in public places. As far as I am aware, the Opposition, despite what they say, had no intention of introducing similar measures if they had won the general election.

Caroline Flint: It is another triumph of this new Labour Government.
	I turn now to the specifics of the amendments. Amendment (b) deals with specialist tobacconists, for which I said in Committee that I was minded to include an exemption. However, that should be tackled in regulations. I reject amendment No. 8, which would remove clauses 1 to 12, as that would effectively kill the premise on which the Bill is based. The view of the public is increasingly that we should take legal measures to restrict smoking in public places.
	The hon. Member for Christchurch mentioned prisons. We are working with the Home Office to determine how to make progress in that respect, but I remind the House that some prisons are smoke free. Prisons are places of detainment and also residence, so we must strike a balance.
	The hon. Member for Birmingham, Yardley tabled amendment No. 10, which would permit local authorities to license and designate premises. The Government believe that a piecemeal approach is inappropriate, as we want a national approach to creating smoke-free places. That is the ideal, but I give credit to those local authorities around the country who have campaigned strongly and made their views known to the Government.
	Several hon. Members spoke about amendment No. 6, which deals with private vehicles. Six Standing Committee sittings were devoted to the smoking parts of the Bill, and I made it clear that there was no intention to require vehicles in exclusively private use to be smoke free. Clause 5(2)(d) makes provision for regulations that may exempt classes of vehicles, including private or rental cars hired for private use. The Bill's regulation-making powers are more than adequate to exempt vehicles for private use.

Caroline Flint: No, but the hon. Gentleman can see me later. We can talk about the regulations. [Laughter.]
	Amendment No. 36 is hard to understand. It seems to be intended to limit the premises that may be exempted from smoke-free legislation to those where a person has his home, or licensed premises and membership clubs. I am worried that it would remove the general regulation-making power in clause 3(1), which takes account of the fact that people who, for example, work on oil rigs are not able to smoke outdoors for reasons of safety. Likewise, if the amendment were adopted, no exemption could be made for laboratories concerned with testing tobacco products. That would mean that the tobacco companies would not be able to test their products, as the law requires them to do.
	Government amendment No. 24 extends the fixed-penalty notice provisions in part 1 of the Bill to the offence of failing to display no-smoking signs, in accordance with the requirements set out in regulations. However, in light of the responses that we received last year, we will add the option of a fixed-penalty notice for the offence of failing to display those signs.
	After the debate in Committee, and as a result of lobbying from various organisations and groups, I am minded to propose that the fines for failing to display no-smoking signs should be raised from a maximum of 200 to a fine not exceeding level 3, which has a maximum of 1,000. I propose to raise the fine for the offence of failing to prevent smoking in smoke-free places from a maximum of 200 to a maximum of 2,500. That sends the strong message to those responsible for enforcing the law that they should make sure that they do so.
	The hon. Member for South Cambridgeshire tabled amendment (i), aimed at protecting children from second-hand smoke in private members' clubs. However, I am perplexed by his argument: first he said that the members of those clubs should be able to decide what happens in their space, but then his amendment seemed to want to tell parents what they should do with their children in those private spaces. That is another demonstration of how the Conservatives are all over the place on this issue.
	I shall finish by recapping on how the new clause and our amendments will work and the choice they offer Members[Interruption.]

Caroline Flint: The hon. Gentleman raised points about substantially enclosed and semi-enclosed premises in Committee, and I am still considering whether some of those areas, including vehicles, should be subject to affirmative resolution. We shall hold full public consultation on all aspects of the regulations, so there will be a chance for everybody in the House and outside to make their views known.
	This week, we launched a new advertising campaign to show the impact of smoking on people's lives, especially for the relatives of smokers. I am grateful that Trudi and her daughters were willing to take part in our campaign. Trudi is dying from lung cancer and, with her daughters of 17 and 11, is already making plans for her funeral. It is important that we realise that smoking affects not only the individual who smokes but those who have to breathe in their smoke as well as those who suffer the devastation of losing someone because of a smoking-related illness.
	The adverts are harrowing and challenging, but alongside them we have launched a series of adverts to bring to our screens examples of two ordinary people who have taken up the NHS stop smoking services, which have never previously been available in that form. The Government realise that the issue is not simply about restrictions in public places, but about providing our health service with funds to help people give up in difficult circumstances, because for many of them smoking is an addiction.
	I am proud that since 1997 we have not only taken measures to control cigarette advertising but, for the first time, provided, through the health service, opportunities for people to give up not just once but to try again if they fail. Today, we are debating legislation that will make a huge contribution to the public health of our nation. If the Bill is successful in the other place, I look forward to working with every Member of the House to ensure that in every constituency, there will be opportunities for people to take advantage of the restrictions to make choices about changing their smoking habits that will affect not just them but everybody they work or live with and everyone they care for.
	Most Members share that aim and there is no doubt that our debates over the past eight months have contributed to a huge public debate, which is good. Often, there is not much discussion in the public domain of what we do in this place, so if that is a sign of positive democracy it is to be welcomed.
	However, the task does not end with passing the Bill and introducing restrictions; 95 per cent. of deaths from cancer are among people exposed to smoking in the home. The Bill is not the end of something, but the start of trying to persuade smokers to give up and to give them every possible support.
	I am pleased that Members on the Opposition Front Benches have moved on the issue[Interruption.] The Tory manifesto was against bringing in legislation, so there has been another period of reflection and consultation. It is always pleasing when the Tories chase Labour to catch up on progressive politics.

Caroline Flint: A voluntary self-regulation system. We have heard it from the hon. Gentleman's own mouth.
	Tonight, we have the opportunity to do the right thing, to do the Labour thing: to vote for health and progress, to show that the Labour Government are always at the forefront of issues that mean something to everybody in the country. As it is 14 February, I wish everyone a happy Valentine's day. If they smoke and they love someone, give up
	It being three hours after the commencement of proceedings on the motion, Mr. Deputy Speaker put forthwith the Question already proposed from the Chair, pursuant to Order [this day].

Question put, That the clause be read a Second time:
	The House divided: Ayes 453, Noes 125.

Andrew Murrison: My hon. Friend is correct. Like me, he will have had constituency experience of the worry involved. People who face the possibility of going to hospital often volunteer the fact that they are worried about it. As I pointed out in Committee, I usually go to some lengths to put the matter in some sort of perspective. Although it is a substantial problemI hope that the figures that I have given underscore thatthe chances of somebody succumbing to such an infection are small. It is important for those of us who try to be responsible to try to reassure people wherever we can.
	The figures speak for themselves, however, and in public health terms, 5,000 deaths a year are significant, so Ministers need to address the problem as a matter of urgency. The way in which they have chosen to do that is to introduce a code. In Committee, we were not particularly happy with the draft code, of which we were heavily critical. I am more than happy to tell the Minister that the version that has been provided more recentlyvery recently, I have to say; it was placed in the Library unheralded and unannounced yesterday, where we found itis an improvement, and I am grateful for it. When we met a little while ago, the Minister said that she would let hon. Members have the revised copy as soon as possible, and she has at least given us sight of it before this debate. We must be thankful for that, although it would have been nice to have had the opportunity to examine it more closely and at a more leisurely rate.
	Last week, we saw some updated figures for MRSA bacteraemia, of which the Minister will be well aware. The raw data for the six-month reference periods since 2001 run at 3,616, 3,584, 3,749 and 3,525. The figure for April to September 2005 is 3,580. The best interpretation of those figures is that there has been little or no change during that period; the level seems to have been pretty well flat-lining. The overall rate per thousand bed days is not entirely clear from the data, only in so far as it is specific for individual trusts. The overall rate for the health service is a little opaque. On the basis of eye-balling the results from trusts, I suspect that the overall rate per thousand bed days would probably give a worse impression of our success or otherwise with MRSA than the raw data that I have just quoted. Sadly, my statistical skills are not quite what they were, so I struggled with the figures presented to me by the Health Protection Agency, but I believe that that is a fair reflection.
	The disparity between trusts that is apparent from the Health Protection Agency data is grounds for alarm but also hope, because it suggests that health care-acquired infection, and MRSA in particular, can be controlled. For example, the fact that Cambridgeshire and Yorkshire can do so well against the record in Somerset and London suggests that infection rates will be reduced by the adoption of best practice. Presumably, that is why the Minister has introduced the code, which is the burden of part 2, and it is also certainly the reason for our insistence that the code should be robust.
	The question is whether the code is robust. In the short period that we have had to examine it, we have formed the view that while it is better than the draft version, it is not quite as robust as we might have liked. On comparing amendment No. 12 and what we have said in Committee with what has transpired, we have found bits that we would commend and that improve the original draft, on which we congratulate the Minister, but we are disappointed by some elements.
	We were pleased to note that one or two of the elements in amendment No. 12 have been reflected. Notably, there are improved lines of accountability, but we note that there is no categorical mention of a board member with specific responsibility for health care-acquired infection control. Perhaps the Minister will clarify that point, as we felt that it was important to nominate at board level somebody with specific responsibility for the matter, perhaps among other duties, and to whom those who carried out hospital policy on health care-acquired infection were responsible. That board-level responsibility is not entirely clear, although we accept that some of the changes in the revised code would improve the prominence of health care-acquired infections at such a level.
	We have also noted that the code now refers to pre-admission screening, which we said in Committee was important, as the Minister will remember. Indeed, there is also some reference to post-discharge surveillance in certain circumstances. I imagine that that has been informed by the University College hospital work in the area, which I am happy has found its way into the revised draft code.
	Other good things have appeared, such as a strong reference to occupational health in hospitals. I freely admit to my interest in the matter, as before I was elected, I was a locum consultant occupational physician at the Gloucestershire Royal hospital, so I have a particular interest in occupational health. I am convinced that the health service has traditionally not done particularly well on occupational health, and I am pleased that it has a relatively high prominence in the revised code.
	I struggled to find much reference to dealing with locum casual and agency staff in the health service. It relies heavily on such personnel, so it is important that any occupational health service captures them adequately. My experience as a locum is that people often simply come and go, and that occupational health and any control mechanisms do not touch them at all. It is important that we deal specifically with such staff. As I said in CommitteeI was perhaps rather too graphicwe do not want any Typhoid Marys wondering around the health service, potentially spreading infection through bad practice or whatever. That is an omission from the code, and perhaps the Minister could reflect on it in her remarks.
	We remain concerned about the lack of clear standards relating to a model cleaning contract, a point that we raised in Committee. Despite the strengthening of lines of accountability that I have mentioned, we are concerned about the fact that managers are still not clearly and indisputably in charge of everything that happens at ward level. I know that the Minister will regard that as a constant Opposition refrain, but we believe in it strongly. Our experience suggests that we need proper control of what goes on at ward level, and we believe that cleanliness and hospital-acquired infections are all rolled up with the lack of control that sometimes exists in our national health service.
	We regret very much the lack of reporting of health care-acquired infections at departmental level. The Minister will remember that we spent some time on these matters, and that I described my personal experience of them. As I recall, we had a slightly light-hearted debate about the cleanliness of doctors' hospital clothingtheir white coats, neckties and so on. My hon. Friend the Member for Mid-Bedfordshire (Mrs. Dorries) spoke at some length about nurses' uniforms. Departments are not ultimately responsible for health care-acquired infections. The national health service is labour-intensive: it relies on its people. At the end of the day, it is people who are responsible for all the good things that happen in our NHS and, sadly, for those areas in which things are done less well.
	Unless we focus on individuals at a level lower than that envisaged by the code, we may miss a trick in identifying less good practice that potentially causes or contributes to a health care-acquired infection, which is why we have insisted that any data should be collected at the lowest possible level, although having read the revised draft code, it does not seem that that point has been adequately taken on board. When we get data, I hope that the report is conducted at a fine level rather than at a macro level, where I suspect that lessons will be lost. I would be delighted if the Minister were to say how she intends to improve that element of the draft code.
	We will watch the Healthcare Commission closely, because, having read the code, it seems that it must do a great deal of interpretation. It will, of course, be responsible for benchmarking one trust against another and I hope that it will apply consistent standards across the health service. The working of the code will depend on how the Healthcare Commission decides to use it.
	As I have said, some trusts are doing well on health care-acquired infection and some are doing less well. The logical extension of the observation that some trusts are doing well but that others are doing less well is that the Healthcare Commission will act against those that are not doing well. It is reasonable to assume that some trusts are doing less well because they do not comply with good practice, much of which is laid out in the code. The matter is, of course, complicated, and some trusts do less well because of the nature of their work, but it is still reasonable to assume that those trusts that are doing less well are to some extent not applying the best practice laid out in the code. I hope that the Healthcare Commission examines that matter and, where it is necessary to do so, implements the necessary measures to make sure that those institutions improve. We will monitor the situation to make sure that that happens.
	Finally, this area is clearly a matter of great concern for a large number of our constituents. It is a pity that the issue has been an also-ran in comparison with the main business of the day, smoking, but that should not disguise the fact that it is important for a large number of our constituents. The Government have chosen to put their store by the code, and, of course, I wish it well and hope that it works. However, I have set out our serious concerns, which I hope that the Minister will bear in mind when she comes to revise the documentas we understand it, the code is a live document that will be revised periodically.

David Kidney: I support the thrust of the amendment, but we have got the law right and are about to get the code right. What is important now is ensuring that the fine words are put into practice in hospital environments up and down the country.
	Before Report, I visited Stafford hospital to talk to hospital staff about protection for patients and visitors to hospitals against health care-associated infections. It was heartening to see that some of the measures that we are debating are already being used in practice. For example, amendment No. 12 suggests that a lead person on the board should take responsibility for that matter, which already happens at Stafford hospital.
	The director of clinical standards at Stafford hospital, Jan Harry, is also the director of infection prevention and control. The modern matron for surgery, Naeema Khan, takes the lead as the internal champion to develop strategies on infection prevention and control, and she has sent me a note reminding me about one or two things that they are up to at the hospital. For example, the national guidance about the Clean your hands campaign has been taken to heart in the hospital, where there is now a network of hand-washing champions, who are role models for staff, visitors and patients.
	To gain community involvementno doubt this is true of many hospitalsthere has been a competition in schools to design posters for the walls of the hospital. That is a sensible way of trying to capture the public's attention, and hopefully people will consider their cleanliness when they are admitted to hospital or visit other patients. Among the many documents reminding hospitals how they should behave, there is now revised guidance on contracting for cleaning. Naeema has informed me that Stafford hospital will be a pilot site for a new ward-cleaning management system and that the relevant preparatory work is under way now.
	In Committee, I discussed capturing information on the level of infection in hospitals, which involves testing and early analysis. Stafford hospital has superb on-site laboratory facilities, so there is the opportunity, with the right guidance, to follow best practice in taking samples, getting assessments, making reports and collecting information. As the hospital has pointed out, however, it could do with some help in its constant fight to keep down health care-associated infections, which requires partnerships that go outside the boundaries of hospitals.
	When I visited the hospital, we discussed care homes for elderly people, which provide many admissions to hospitals these days and which, like hospitals, are an environment where we might anticipate a degree of infection unless care is taken. My hospital and its partners, which include residential care providers, are willing to undergo joint screening and to export good practice from the hospital to those homes. Sadly, the hospital has found that there is a cost, and unless people feel particularly motivated, they will not incur it unless they have to. As politicians, we can take the message to potential partners and hospital trusts that there is something that everyone should do.

Nadine Dorries: I wish to speak to amendments Nos. 35 and 37.
	MRSA rates have doubled since 1997, as my hon. Friend the Member for Westbury (Dr. Murrison) pointed out. The last time we debated this in the House, the hon. Members for Thurrock (Andrew Mackinlay) and for Wyre Forest (Dr. Taylor) spoke at length about the misreporting of figures. Although current figures suggest that we do not have a massive problem, it is still one that we cannot fully identify in terms of knowing what the true figures are.
	However, I am not here to lob grenades across the Table by criticising the Government. I want to look at where we are now and how we can move on to improve the situation. I well remember the NHS in the 1970s under a Labour Government, and in the 1980s under a Conservative Administration. The most fearful bug that we had to deal with in those days was klebsiella, which lived on bars of soap. Things are different now.
	I am not naturally a retrospective person, but in the matter of MRSA one has to be. In the 70s and 80s, hospitals were indisputably much cleaner than they are today. However, it is not just a decline in cleanliness that has brought about MRSA in our hospitals; it is also the result of an over-reliance on antibiotics, increased movement of patients within the hospital estate, centrally imposed targets that pressurise hospital staff and administrators to hot-bed patients by getting a patient into a bed before it has gone cold or has even been cleaned properly, and dirty wards and bathrooms. A combination of those factors causes MRSA in hospitals.
	There is another factor which causes me, as an ex-nurse, some embarrassment. It is easily preventable. I discussed it with the Minister in Committee and was disappointed to note that it was not addressed in more detail in the draft code of practice. It is the fact that nowadays nurses travel to and from home in their uniforms. We all know that that is the case. How often do we see a nurse outside the school gates picking up her children, going into a nursery to pick up her toddler, or leaning over the vegetable section in a supermarket while getting groceries on her way into work? We cannot blame nurses for that because changing facilities are no longer available as they used to be. One has to ask why that is.
	One also has to ask on what this casual behaviour of travelling around in nurses' uniforms is based. Is it based on the premise that nurses believe that the uniform is there to protect them, or doctors, from patients and to keep them clean? If so, that is extremely misguided. The purpose of the uniform is to protect the patient from the nurse or the doctorthe patient who, as a result of being in hospital for procedures or from illness, needs to be protected from anybody who enters their vicinity, including nurses and doctors.
	My amendments relate directly to that situation and are simple and to the point. Hospital staff with direct responsibility for patients should not place them at risk by wearing their uniforms to and from work. That is wrong, and it is undoubtedly a direct contribution to MRSA in hospitals.

Stephen Williams: I should like to have spoken at greater length in the earlier debate on smoking. None the less, I am delighted with the outcome. Clearly, my wise words were not needed.
	Four or five years ago, we conducted a major survey in my constituency on health care services in Bristol. The most common spontaneous remarks expressed concern about standards of cleanliness in hospitals in the city. In the verbal surveys about health care that we conducted on the doorstep, people often commented on that, and it is therefore right to raise the matter now. We also discussed it at length in Committee.
	Proposed new paragraphs (e) to (j) in amendment No. 12 make sense. Proposed new paragraph (d) is also important because it is obvious that the infection control nurse needs to report directly to somebody, but I wonder whether we need to appoint a separate trust director for that role. As my hon. Friend the Member for Stafford (Mr. Kidney) pointed out, the medical or clinical director of most acute trusts is likely to hold such a responsibility alreadyfrom memory, that is the case in Bristolbut there may be some merit in making that publicly known.
	Let me deal with amendments Nos. 35 and 7, which the hon. Member for Mid-Bedfordshire (Mrs. Dorries) tabled. I wonder on what evidence she based her remarks, because much of it appeared anecdotal. Is there such evidence in the public domain? Perhaps the Minister could comment on that. How widespread are the abuses of standards of cleanliness that the hon. Member for Mid-Bedfordshire described? Has she spoken to representatives of the Royal College of Nursing, Unison or any other representative bodies in the health service?

Sandra Gidley: These amendments seek to amend clause 32, which deals with application for provision of pharmaceutical services. It may be worth spending a little time on the context of these amendments. As the House knows, following the Office of Fair Trading consultation a couple of years ago, new pharmacies are controlled by something called the control of entry regulations. Any application to open a new pharmacy has to go before the primary care trust or the Assembly in Wales and has to pass certain tests.
	It is also worth remembering that pharmacies are private contractors which have a contract with the national health service. Historically, that has been to deliver dispensing services, but that has recently changed with the introduction of the new pharmacy contract. That seeks to extend the role of pharmacists, which is widely regarded as a good thing.
	Instead of just relying on dispensing, the contract is divided into levels of service. The standard services are those that all pharmacies should supply, and include services such as dispensing and health promotion. Advanced services are developing gradually and the first, which has been successful so far, is the medicines use reviewor MURwhich has benefited many patients. So far, so good. The potential exists for enhanced services, such as smoking cessationI had to mention that tonightand monitoring the progress of disease or providing services to care homes. Commissioning of such enhanced services has been very patchy. Some primary care trusts have been very good and tried to embrace new services, but others have ignored the opportunity completely. Some of the evidence shows that the future of the enhanced services next year looks shaky, to say the least. However, that is probably a debate for another day.
	Clause 32 applies only when a primary care trust has two applications before it to provide pharmaceutical services in a similar locality. Each pharmacy must pass the existing test as to whether it is necessary or desirable.
	As drafted, clause 32 would mean that an NHS contract could be awarded according to promises made in relation to the commercial part of the business. That is wrong and unenforceable, and various problems arise. I admit that the Government have consulted on the proposal, but most respondents rejected it. All the contractors who were consulted did so, regardless of whether they represented single, independent contractors or large multiples.
	The contractors' objections revolved around a few simple propositions. They said that no request for a certain level of medicine pricing could be enforced, as no price could be guaranteed in the long term. Contractors could promise the earth, but how could that be monitored by the PCT on a regular basis? What would happen if circumstances changed? For example, a certain price for over-the-counter medicines might be allowed, but the company or pharmacist involved could renege on the deal.
	The best analogy that I can come up with is with the contracts awarded to NHS dentists. Such dentists spend two or three years building up their patient lists, but then decide that they do not want to provide dentistry on the NHS. In those circumstances, the PCT has no control over what happens, and it is the question of control that is important here.
	Also, it is difficult to see how a PCT can balance different offers in different applications. For example, one pharmacy might offer a certain price for over-the-counter medicines, while another offers an enhanced delivery service. How can the first offer be compared with the second? Who decides what is best for patients? During the consultation, the concern was raised that the proposal could lead to more application refusals being contested, and therefore to a possible increase in the number of judicial reviews.
	What happens if a pharmacy is sold, quite legitimately, to an independent contractor or a different group? The buyer might have different marketing or pricing policies, or want to offer a different range of services. How will that be dealt with?
	It has been argued that the proposal will help disadvantaged communities, as they would have access to cut-price medicines. I have worked in such communities, and my experience is that that is not really a consideration. People who live in such areas know that they can get free prescriptions from their GPs, and are happy to do so. As a result, that argument is something of a red herring.
	Very often, businesses in disadvantaged communities are run by independent contractors. At first, they might not be able to offer big attractions in respect of cut-price medicines, but their commitment to the community can mean that they choose to plough some of the profits back into developing future services. Traditionally, that is what has happened in pharmacy, but the clause could put a stop to pharmacists' very realistic desire to do the best that they can within the constraints of their budgets.
	In short, the clause is unworkable as it stands, being difficult both to monitor and sustain. If the Minister is committed to proceeding with it, I hope that she will at least review the new system after it has been in place for a year or 18 months. In that way, she will be able to see whether any of the problems that I have highlighted are based in reality rather than in fear.

Jane Kennedy: We are discussing the narrow focus of clause 32. When determining chemist applications to provide pharmaceutical services, current legislation means that PCTs cannot take into account additional services that the chemist might offer.
	When PCTs are looking at competing applications that relate to the same neighbourhood and which individually all pass the necessary or desirable tests, clause 32 will allow them to consider the improvements that each chemist would bring to the provision of over-the-counter medicines and other health care products, as well as associated advice.
	Our proposal aims to encourage applicants to offer improvements generally to the range and availability of medicines and services to support self-care; for example, through helping people to manage minor ailments and promoting healthier living through better advice and information about such products. The hon. Member for Romsey (Sandra Gidley) expressed concern that smaller businesses might not be able to fend off bigger competitors. She also argued that the clause was not sustainable or workable.
	I do not share the hon. Lady's pessimismor I would not be proposing the measure. The important point is that although the price of over-the-counter medicines must obviously be a factor, the clause is not simply about price; to a large degree, it is about support and advice to the patient in the management of such medicines.

Jane Kennedy: I hear what the hon. Lady says, but her amendment would prevent PCTs from considering what improvements applicants would bring to the provision of over-the-counter medicines in certain cases, which is specific and narrow. Instead, PCTs would be limited to considering only the provision of advice and a range of other health care products, such as dressings, incontinence appliances or sunscreens. That is important and would be welcomed by everybody, but I do not accept the concerns expressed by the hon. Lady, so I hope that the amendment is a probing one. I appreciate that we are on Report, but there may be further time to consider the matter in another place.
	The clause is in line with our policy of opening up and developing community pharmacy services. It will improve the availability of over-the-counter medicines in deprived communities. I hope that the amendment was a probing one and I ask the hon. Lady not to press it to a vote. I will consider her comments and perhaps I can respond at a later date.

Andrew Murrison: I will not press the amendment to a vote but very much hope that we will find ourselves in violent agreement with the Government, who have consistently made it clear in Committee and during today's proceedings that they favour the affirmative procedure in respect of regulations, which flow like the Tiber through the Bill. Amendments Nos. 33 and 34 would simply ensure that the affirmative procedure would be applied to clause 5, which clearly deals with vehicles, and clause 2, in respect of which we are particularly concerned about the definitions of what is enclosed, substantially enclosed, not enclosed and so on. The Minister must agree that that it is important, given the uncertainly that surrounds such things, that the regulations that the Secretary of State may wish to enforce are subject to the affirmative procedure.

Patricia Hewitt: I beg to move, That the Bill be now read the Third time.
	I am proud to move the Bill's Third Reading. I particularly want to thank the Minister of State, Department of Health, my right hon. Friend the Member for Liverpool, Wavertree (Jane Kennedy) and the Under-Secretary of State for Health, my hon. Friend the Member for Don Valley (Caroline Flint) who have done a superb job in piloting the Bill through Committee and much of the Report stage that we have just had. [Interruption.] Despite some of the sedentary comments by Opposition Members, I also pay tribute to Members on both sides who have adopted a positive and constructive attitude to the elements of a Bill that not only protects public health inside and outside hospital but that will further improve the performance and efficiency of the national health service.
	Of course, the main focus of our debate and of public attention has been on the Bill's smoking provisions. This evening, the House voted absolutely decisively to introduce a complete ban on smoking in all enclosed public places and workplaces, including all licensed premises and private members' clubs. We have therefore not only delivered on the manifesto promise to ban smoking in virtually all public places and workplaces on which we were elected 10 months ago but have gone additional steps further. That reflects the excellent debate that took place on the smoking provisions in which I and my hon. Friends, who genuinely believed, and always have, that the arguments about private members' clubs were finely balanced, have none the less voted for a complete ban, particularly in the interests of ensuring a level playing field between different businesses such as small pubs and members' clubs. I recognise that there will be some disappointment among at least some members of private clubs at the outcome of the vote, but I nevertheless believe that it was the right one.
	The comprehensive ban for which the House has decisively voted will mean, over time, that some 600,000 people, beyond those who would have otherwise given up smoking, will be led to abandon it. The result of that and the protection that we are giving to people from second-hand smoking will be thousands of people's lives being saved and thousands of families being spared the grief of losing a loved one prematurely. That is why I think today's vote and the Bill will be seen as historic legislation on public health equivalent to, for instance, the legislation on seat belts of some decades ago.
	I am also delighted that, although it was not debated this afternoon, we have also taken power to raise the age for the purchase of tobacco from 16 to 18 following the consultation in which we engaged. I pay tribute to my hon. Friend the Member for Barnsley, East and Mexborough (Jeff Ennis), who has campaigned vigorously and effectively on that issue.
	Other vital provisions include the statutory code of practice on MRSA and associated health care infections. It will be very widely welcomed not only by the public, who quite rightly expect every hospital to get down their MRSA and other infection rates, but by staff in both the NHS and the independent sector.
	The Bill will also provide for much stronger management of controlled drugs in response to some of the shortcomings identified in the Shipman inquiry and will improve safeguards against the very small minority of people who would divert those drugs for personal abuse, financial gain or even, regrettably, for criminal purposes. It will also help us to continue improving and modernising NHS pharmacy services, ensuring, as my right hon. Friend the Minister of State said, that we can continue expanding the services offered by our pharmacists and make them much more convenient to patients.
	I was pleased to read the discussion in Committee during which the provision of ophthalmic services in England was praised. Although there was concern that the Bill would tamper with a service that is already excellent, I hope that hon. Members on both sides are reassured that by removing the restrictions on with whom a primary trust may contract to provide ophthalmic services the Bill will help to increase patient choice and thus continue to improve services. The new framework for ophthalmic services will ensure that we will be able to provide enhanced services in the community of the kind that are often available at present only in hospitals. That will be in line with the direction that we have just spelled out in the White Paper.

Andrew Lansley: I am never churlishcross, perhaps, but never churlish.
	I agree with the Secretary of State that we have engaged in constructive discussion at every stage in the Bill's progress. That was very true in Committee, where the hon. Member for Barnsley, East and Mexborough (Jeff Ennis) and my right hon. Friend the Member for North-West Hampshire (Sir George Young) rightly pressed for an increase in the age at which tobacco can be purchased. I am delighted that we have moved in that direction. However, even though I have no doubt that another place will respect the decision of the House on a free vote, and with a significant majority at that, it should consider issues relating to smoking including definitions, what additional places will be specified under the legislation, under what circumstances private vehicles might be specified, and whether vehicles used for work are to be included in the smoke-free provisions. Those are important matters, and some valuable work will no doubt be done in another place.
	We have not discussed specialist tobacconists, but I hope Ministers will understand the desire for them not to be put out of business. I should also mention penalties, which we discussed in Committee. I was not entirely happy with the scale of penalties that the Government proposed. In some respects they have been increased, which the Minister thinks appropriate, but I hope that that will be reconsidered in another place and weighed up relative to other legislative penalties.
	As our last group of amendments made clear, the nature of the regulatory provisions and how they are to be made is important. In addition to the remarks of my hon. Friend the Member for Westbury (Dr. Murrison), we suggested in Committee that it might be better for the regulations to be made by affirmative procedure in the first instance, rather than by affirmative procedure in every case. Subsequent technical amendments to the regulations could be made by negative procedure, but the initial regulations, which will contain substance as well as technicalities, might well be made on an affirmative basis.
	We discussed infection control previously and had the opportunity to raise some of the issues on Report and in discussions with the Minister in Committee and elsewhere. The issues are important and intractable. As the Minister will acknowledge, the latest six-monthly MRSA statistics do not show the progress that she and we might have wished. That demonstrates the difficulty of making progress and the necessity for the measures described in the code to be implemented effectively. Isolation facilities must not only be appropriate but must follow a risk assessment. We need to work on the design of hospitals and ensure that the necessary facilities are built in from the outset.
	Clinical data, which the Minister agreed should be collected by a clinical department, should be used as a performance management tool in hospitals to deliver improved infection control, should be a basis on which health care providers are held to account, and should be used by them better to inform public debate about infection control. One of the central issues that we constantly try to highlight is the distinction between prevalence and incidence. Not all incidents of infection in hospitals are by any means the consequence of infection being contracted in hospital. Distinguishing between the two can make an enormous difference to public understanding. I hope that another place will take a substantial interest in those matters and in model cleaning contracts, nursing uniforms and standards. Committees in another place have done significant work on those aspects in the past, and I hope they will follow it up.
	We hope that the pharmacy contract will increasingly be implemented innovatively. Only a few weeks ago, we discussed the White Paper and the desire for greater opportunities for people to be screened for disease and to initiate for themselves more checks on their health status. It is perfectly clear that pharmacies can do a great deal in that direction, and the pharmacy contract always allows that. The issue is whether primary care trusts are contracting for such an approach. One aspect that needs to be followed up is not merely legislating or contracting for such possibilities, but ensuring that the structure of commissioning inside primary care trusts with regard to pharmacies allows for them.
	One issue that we have not had a further opportunity to discuss is the span of control of a pharmacist, and I hope that those in another place will pursue it. The professional confidence that we place in pharmacists is important, and the profession itself attaches considerable importance to that. Many pharmacists do not want to move beyond the rule of one pharmacy, one pharmacist, or if they do, it is only in very exceptional circumstances and it must be delineated. I do not think that we have yet arrived at a point at which it is delineated in the Bill, and I hope that that will be pursued further.
	On general ophthalmic services, the Secretary of State made it clear that PCTs should pursue the maximum choice consistent with value for money for the Exchequer. That must be true. Many people are wondering precisely what the motivation is for the legislation and what is going wrong in general ophthalmic services that demands such a change. Currently, optometrists and registered opticians can offer services, and patients can use them; they have maximum choice, and there does not seem to be a difficulty with that. If we are to move to a new design, let us ensure that those things continue. Let us ensure that the central funding is clearly set out, either in the legislation or in ministerial commitments for the future, so that the free sight test is available and cannot be compromised by budgetary pressures on individual primary care trusts; that the scope of the sight test can be adapted in line with best clinical practice as we move forward; that optometrists and opticians are able and encouraged to provide sight tests and related tests that not only focus on the basic question of visual field, but go beyond to trying to detect disease to the maximum extent; and that the free sight test itself is not infringed in years to come.
	We have spent almost three months on the legislation. In many ways, it has ended up where I suspect many of us thought and said it would, although not necessarily as easily as it should have done. Many parts of the Bill are of a nature that commands consensus across the House. On smoking, many of my colleagues object[Hon. Members: Yes.] I know that they object to what the House has decided, but frankly, it was always our view that the matter was best dealt with on a free vote. Since we have at last come to that and the House has taken a decision on a free vote, for my part, whether or not I agree precisely with the outcome, I think that that is a fair basis for the House to reach its conclusion. I am content for the legislation as a whole to go to another place in its current form, and I hope that it will be further improved there.

Steve Webb: The whole House will congratulate the hon. Member for Barnsley, East and Mexborough (Jeff Ennis) on pursuing an issue and seeing it through to the point where the public and the industry will be consulted and then the House can form a view through affirmative resolution. When we debated the programme motion, I said that it was an important issue that warranted a debate. As I predicted, we did not get it. Very few people in the Housethe hon. Member for Barnsley, East and Mexborough was one of themknew what was happening when the Speaker called for new clause 6 to be added to the Bill. Such an important issue should have got an airing so that we could think it through further. At least the House has a chance to come back to it once a consideration has been made.
	It is always a good day when a Liberal Democrat manifesto policy is implemented. Of the manifestos of the three major parties, only the Liberal Democrats' contained a total ban on smoking, so my colleagues and I am delighted by the outcome of today's vote. It goes further. Of the three Front-Bench speeches that opened our debate, only onemodesty forbids my saying whichunequivocally argued for a total ban, which is what the House overwhelmingly concluded, no doubt persuaded by the oratory. To sway the House, on a free vote, to a majority of more than 200 is one of my early parliamentary highlights but no doubt not the last.
	I congratulate the Committee members who assiduously went through the Bill. I was about to say some nice things about the Under-Secretary of State for Health, the hon. Member for Don Valley (Caroline Flint), but she has left. The hon. Member for South Cambridgeshire (Mr. Lansley) was uncharacteristically ungenerous in his remarks about her, because she dealt with all the smoking aspects of the Bill in Committee, although I am not sure that one praises someone for arguing for something that they do not wholly believe in. She was obviously committed throughout to a full ban, and it was poetic that she tabled the amendment that brought it in. That seems only right and proper.
	I agree with the hon. Member for South Cambridgeshire that the Bill has not been well handled by the Government. In a sense, the Under-Secretary inherited a compromise. It is good that, through the evolution of the provisions, we have ended up with a clearer position. I was just discussing signage with my hon. Friend the Member for Bristol, West (Stephen Williams). Presumably we no longer need to put up signs saying that people cannot smoke in these places because it is now the law of the land that one cannot smoke in an enclosed public place, wherever it is. That is one example of how much cleaner, simpler and more effective is the total ban that the Bill now contains. I thank my hon. Friend the Member for Bristol, West, who served on his first health Bill Committee with me and made an important contribution to the debates.
	Although the debate was predominantly about smoking, we also heard about MRSA and related issues. My hope would be that, although we have yet another initiative or taskforcea code of practice, in this caseit will have real teeth. The record so far is disappointing. The Minister of State, Department of Health, the right hon. Member for Liverpool, Wavertree (Jane Kennedy) said that the most recent set of figures on MRSA were disappointing in that they are no lower than they were 12 months ago. I join the Government in hoping, if not with a great deal of confidence, that the code of practice will bite and that we will see real changes. That is what we all want.
	In the event of a maverick voteI do not know whether one is plannedI will, with great pleasure, encourage the serried ranks of my colleagues to support the Bill's Third Reading.

David Kidney: I, too, participated in the Second Reading debate and served on the Standing Committee. It is right to praise the Ministers who steered the Bill through proceedings in this House and the Members who served on the Committee. Ministers listened to concerns expressed on Second Reading and acted in Committee. An example is the changes made on ophthalmic services. Ministers listened to cogent arguments put forward by my hon. Friends in Committee and acted on Report to make changes, the best example being on the minimum age for buying tobacco.
	All those MembersI hasten to add that I was not one of them, so I am not praising myselfwho diligently chipped away, day after day, at the arguments about the distinction, as regards the smoking ban, between public houses that did and did not sell food have had their day. They exposed the weaknesses of that distinction and forced hon. Members to make a starker choice between the status quo and a complete ban. A pretty convincing opinion has been expressed in the House on a free vote.
	The proceedings have therefore been a success so far. One half of the process has been completed and the Bill will be off to the other place. However, as a postscript, I want to mention my disappointment about the process in this place. Through a spark of ingenuity, I persuaded House officials to accept that amendments about breast feeding came within the Bill's remit. By a stroke of good fortune, the Committee Chairman selected them for debate. Alas, I was struck down by the timetable that was imposed on our deliberations in Committee. My new clauses on breast feeding probably constituted the one issue of substance that was never considered in Committee. The Speaker did not select them for debate today. They will not be considered in the context of the Bill in the House of Commons, but I believe that they raised important issues of public health and discrimination, which must be left for another day.
	I do not know whether the same spark of ingenuity can strike twice and enable me to find another way to raise those important matters in the near future, but I look forward to the guidance on breast feeding from the National Institute for Health and Clinical Excellence later this year because we have a poor record in this country

Rob Marris: I believe that before he was elected the hon. Gentleman worked for Asda. Asda has bacon-slicing machines in its workplaces. Does the hon. Gentleman believe that, in a reputable company like Asda, if a bacon-slicing machine was not guarded it would be up to the individual to decide whether to take a job working with that unguarded machine, thereby risking cutting off his fingers, or does he believe that there should be legislative protectionas there is, and as I believe there should be?

Canadian Seals

Judy Mallaber: I dedicate this debate on the commercial Canadian seal hunt to the memory of Tony Banks, an extraordinary campaigner for animal welfare. Today, I received a letter supporting us in the debate from Sally Banks, who has taken up the baton. She says:
	Tony's passionate opposition to this barbarous hunt is the reason that I have pledged to continue his work.
	Sally says that the issue was close to Tony's heart, so perhaps it is appropriate that on Valentine's day we are holding a debate on the massacre of seal pups for their furappropriate as long as we win the argument and achieve the ban that we all want.
	Last year, the Humane Society of the United States witnessed and filmed the killing of harp seals to the north of Prince Edward island. This morning, I watched the film again; it does not make for easy viewing. It starts with a seemingly endless shot of a seal pup gurgling slowly to death in its own blood. I challenge anyone to watch that film and not be sickened, and not to want to do all that we can to stop such barbaric slaughter. The main contribution that we can make in this country is to block the trade in seal products that fuels that slaughter. I shall discuss the legal case for such a ban, but first I shall set out the arguments for a ban and, secondly, the Government's opposition to the seal hunt, which has already been expressed in a previous Adjournment debate in 2003.
	The callous routine brutality used by those who kill the seals must be seen to be believed. In that film, the sealers can be seen running from seal to seal, hitting as many as they can, as quickly as they can. They do not even stop to see whether the seals that they have hit are dead. Those in the film show as much regard for the rules as they do for the seals.
	The Canadian GovernmentI have a letter to this effectclaim that the hunt is humanely conducted, but I have detailed quotes from two experts who viewed the film footage. Dr. Donald Broom, professor of animal welfare at Cambridge university, notes that many of the seals were still conscious after being clubbed. The chief veterinary officer of the Royal Society for the Prevention of Cruelty to Animals, Dr. Steve Cheetham, was appalled and talks of pain and suffering and the incompetence of the sealers, but that is clear to anyone who looks at the film, the end shot of which shows a seal struggling, exhausted, in a pool of blood and icy water.
	The conduct of the hunt is partly due to the way that the Canadian Government design the quota system. An overall limit is set, so the sealers race around to kill as many seals as they can individually and by boat until the total is met. The hunt is inherently cruel. Many people, probably most people, do not even realise that the hunt still happens each year. They think that it ended back in the 1980s, but in fact, twice as many seals are killed today as back then and it is the largest, most brutal slaughter of marine mammals anywhere on the planet.
	In 1983, a long time back, the European Economic Community banned the import of furs and products made from whitecoat sealsnew-born harp seals until they begin to moult when they are just 10 days oldand bluebacks, which are young hooded seals. The sealers now cynically wait a few days until the harp seals are approximately four weeks oldstill pups, unable to swim and have never eaten a solid meal. In the United States, it is illegal to trade in marine mammal products and there is no Canadian market, but those clubbed seal pups have moulted, so their skins are legally imported into the European Union and the United Kingdom. The crux of tonight's argument is to stop that trade.
	The last time that the Canadian seal hunt was debated in the House was on 4 November 2003, when the then Minister for Trade and Investmentnow the Solicitor-Generalstated that the Government
	do not accept the need for any seal cull.
	He continued,
	we do not accept that clubbing is acceptable.
	He said that it
	does Canada's reputation a great deal of damage.[Official Report, 4 November 2003; Vol. 412, c. 21921WH.]
	He also said that the Canadian Government had been asked to consider a total ban on the commercial seal hunt. Since that debate, more than 600,000 seal pups have been clubbed to death or shot on the ice floes of eastern Canada during two more years of the commercial hunt. I will not quote the horrific description of a seal being skinned alive while still conscious, given by the hon. Member for Southend, West (Mr. Amess) in that debate a couple of years ago. Many seals escape from being shot to die in agony from their injuries.
	It is abundantly clear that the Canadian Government continue to ignore our Government's overtures, as well as public opinion, including that of the majority of their own citizens who want an end to the hunt, according to a survey commissioned by the International Fund for Animal Welfare in Canada in 2005. The Canadian Government also ignore evidence on conservation and biodiversity issues. I have here a review by Professor Stephen Harris, who shows that the Canadian modelling of the seal population and quotas is unsafe and that there is a serious threat to the survival of the seal population.
	To get to the heart of the matter, what should our Government do? What are we asking? What action do we want? Part of the problem with the United Kingdom's position is that by continuing to allow the import of seal products that come from the hunt, the Government are sending out a mixed message to Canada. On one hand, they say that they disapprove of the hunt, while on the other, they are saying that it is okay to trade in the products. It is not, and until we ban the import and trade in all the hunt's products, we too have the seals' blood on our hands.

Judy Mallaber: I thank my hon. Friend for that extremely helpful information.
	The trade has been banned in the United State since 1972. Greenland, which carries out its own indigenous seal hunt, recently stopped all imports of seal skins from Canada. I understand that that happened just after pictures of the Canadian seal hunt were broadcast on national TV there. If the film that I watched this morning was shown on our television, the Minister would be inundated with requests to ban hunting, although I am not sure that our television companies would wish to show such horrific filming.
	Earlier this week, the Italian Government announced a temporary ban on the import of seal products and announced their introduction of a Bill to end the trade permanently. Mexico decided last week to prohibit the trade in all marine mammal products, and Belgium now has a licensing scheme for imports, but has made it clear that no licences will be issued and that it will also bring in comprehensive legislation.
	The case for banning the import of, and trade in, seal products is now overwhelming. A recent opinion poll commissioned by Respect for Animals found that 79 per cent. of people in Britain want the seal hunt to be banned and that 73 per cent. agree that the Government should act to ban the import of seal products. I pay tribute to Respect for Animals, which has provided me with information for this debate. It is based in the constituency of the Lord Commissioner of Her Majesty's Treasury, my hon. Friend the Member for Gedling (Mr. Coaker). If he did not have to act as a Trappist monk as a Whip, I know that he would wish to be up here introducing the debate.
	I specifically wish to ask my hon. Friend the Minister to confirm that he has seen the legal opinion obtained by Respect for Animals and IFAW and given by Philippe Sands QC, one of the world's leading experts on international law and European trade. It shows in great detail the legal basis for his clear and strong view that the UK, under World Trade Organisation rules, can legally ban the import of harp and hooded seal products.

David Taylor: The Canadian Government often argue that this barbaric practice continues in order to protect fish stocks and the recovery of those of Atlantic cod. However, recent global studies show that marine mammals very rarely conflict with the fish that are commercially fished. There is relatively overlap, so that argument does not hold water.

Ian Pearson: Let me respond directly to my hon. Friend by giving her my commitment that I will talk to civil servants about the legal opinion and that I am very happy to have meetings with her and NGOs on the issue, and to fully explore it and see what can be done.
	The Government take every appropriate opportunity to remind the Canadians of our opposition to the hunt. I assure the House that we will continue to review the options for tighter restrictions or a ban on trade in seal products in the light of the legal opinion and issues of sustainability, conservation and animal welfare.
	The motion having been made after Ten o'clock, and the debate having continued for half an hour, Madam Deputy Speaker adjourned the House without Question put, pursuant to the Standing Order.
	Adjourned at twenty-eight minutes to Eleven o'clock.

CORRECTION

8 February 2006: In col. 972, In Ayes insert Cunningham, Tony.